All ETDs from UAB

Advisory Committee Chair

Elizabeth Baker

Document Type

Thesis

Date of Award

2024

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

Transgender and gender nonbinary individuals, hereafter referred to as trans, report worse health outcomes than trans individuals whose gender identity matches their sex assigned at birth, hereafter referred to as cisgender (Bauer, Hammond, Travers et al. 2009, Cicero, Reisner, Merwin et al. 2020). Past research has indicated that social determinants of health, such as education attainment, may be responsible for these inequities (Low 2006, The Lancet Public 2020). Education’s influence on health is well known from previous research, but the association is not distributed equally. In the United States (US) educational system, state and local governments have control, not the federal government. Even at the federal level, no law applies protections to students to ensure that they are free from any form of harassment or violence based on their gender identity. This decentralized form of governance creates differences in funding, curriculum, and many other policies and procedures that are associated with how education is delivered to the masses. Using the Behavioral Risk Factor Surveillance Survey (BRFSS) 2014-2020, a nationally representative probability sample of adults in the U.S., I will examine how education impacts and influences the disparities between trans and cisgender individuals on self-rated general health and self-assessed mental health. Results of the logistic regression analyses demonstrated that trans individuals had lower odds of reporting only good mental health days and lower odds of reporting good self-rated health than cisgender individuals. Results of the interaction effects between gender identity and education demonstrated reduced impact of educational attainment on self-rated health, but the impact of education on good mental health days did not vary by gender identity. Lastly, increasing education is significantly associated with better health for both trans and cisgender people, but the influence was significantly diminished for gender minorities. The current study underlines the important role of educations influence of the health of trans individuals. This finding supports the theory of learned effectiveness (Mirowsky and Ross 2017) through the significant health improvement when an individual completes a high school degree compared to those with less than a high school degree on self-rated health. However, findings also support the diminishing returns theory, where members of marginalized statuses receive fewer health benefits from increasing resources, including education (Assari and Bazargan 2019b, Sutter, Perrin).

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